Improving access to care isn’t just a capacity, scheduling, or affordability problem. It’s a culture problem. Systems that are pulling ahead treat access as a system capability with shared accountability: they unlock capacity they already own, standardize how the system works, and manage experience as a measure for access. This article distills lessons from four health systems that executed on those principles:

• Inova Health (Inova) uncovered hidden capacity by standardizing core operational and clinical processes (provider scheduling templates, visit-type definitions, and workspace and hoteling standards).

• Sutter Health (Sutter) mandated systemwide online scheduling for new and returning patients across family medicine, internal medicine, and pediatrics, as well as for return-visit scheduling across all other specialties. Sutter established a systemwide standard expectation to enable online scheduling for new and returning patients across family medicine, internal medicine, and pediatrics, as well as for return-visit scheduling across all other specialties. Within 90 days, they standardized 2,300 primary care templates and broke through years of incremental progress.

• Emory Healthcare (Emory) used a three‑month “pressure‑cooker” sprint to add 800+ daily ambulatory arrivals with no new clinical FTEs. They proved what’s possible with a hard reset and then locked in gains with a three‑year roadmap to embed sustainable, standardized access practices across the enterprise.

• Intermountain Health (Intermountain) elevated consumer experience management to a systemwide responsibility and built a near-real-time, experience management system that helps identify and remove access barriers.